J Cancer 2016; 7(1):7-13. doi:10.7150/jca.13081

Research Paper

Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions

Bojan Zaric1, Vladimir Stojsic1, Vladimir Carapic1, Tomi Kovacevic1, Goran Stojanovic1, Milana Panjkovic1, Ioannis Kioumis3, Kaid Darwiche2, Konstantinos Zarogoulidis3, Grigoris Stratakos4, Drosos Tsavlis3, Wolfgang Hohenforst-Schmidt5, Georgia Pitsiou3, Athanasios Zissimopoulos6, Nikos Sachpekidis7, Ilias Karapantzos8, Chrysanthi Karapantzou8, Paul Zarogoulidis3✉, Branislav Perin1

1. Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia
2. Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, University of Duisburg-Essen, 45239 Essen, Germany
3. Pulmonary Department-Oncology Unit, “G. Papanikolaou“ General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
4. Department of Interventional Pneumology, “Sotiria“ Hospital of Chest Diseases, Athens, Greece
5. Medical Clinic I, ''Fuerth'' Hospital, University of Erlangen, Germany
6. Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
7. Thoracic Surgery Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece
8. Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece

Abstract

Background: EBUS guided trans-bronchial biopsy became routine in diagnosis of peripheral pulmonary lesions (PPL). Suction catheter-biopsy is a technique for obtaining a tissue sample from peripheral lung parenchyma. Aim of this study was to evaluate diagnostic efficiency, feasibility and safety of EBUS guided suction catheter-biopsy (SCB) in comparison to trans-bronchial biopsy (TBB) in diagnosis of PPL. The main intention was to demonstrate non-inferiority of the technique over trans-bronchial biopsy, especially when used under navigation of the EBUS.

Methods: Radial EBUS probe (UM-3R, Olympus Co, Japan.) without guiding sheath was used to navigate suction catheter and TBB forceps to the PPL. The catheter was connected to the collection canister via vacuum pump. The SCB specimens were fixed with 10% buffered formalin.

Results: There were 168 patients enrolled in this study; 69.9% males and 30.1% females. Main lesion diameter was 4.1±1.9 cm. Majority of patients, 131(77.9%) were diagnosed with lung cancer. Per-biopsy calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for EBUS-SCB were 92.4%, 100%, 100% and 67.7%, respectively. Corresponding values for EBUS-TBB were 92.3%, 100%, 100% and 69.7%. Only the size of the lesion significantly influenced (p=0.005) diagnostic performance. Complications occurred in 2 patients; one pneumothorax and one excessive bleeding.

Conclusion: EBUS guided SCB is efficient, feasible and safe in diagnosis of peripheral lung cancer. The technique is complementary to trans-bronchial biopsy.

Keywords: bronchoscopy, endobronchial ultrasound, EBUS, interventional pulmonology, lung cancer, peripheral pulmonary lesion

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How to cite this article:
Zaric B, Stojsic V, Carapic V, Kovacevic T, Stojanovic G, Panjkovic M, Kioumis I, Darwiche K, Zarogoulidis K, Stratakos G, Tsavlis D, Hohenforst-Schmidt W, Pitsiou G, Zissimopoulos A, Sachpekidis N, Karapantzos I, Karapantzou C, Zarogoulidis P, Perin B. Radial Endobronchial Ultrasound (EBUS) Guided Suction Catheter-Biopsy in Histological Diagnosis of Peripheral Pulmonary Lesions. J Cancer 2016; 7(1):7-13. doi:10.7150/jca.13081. Available from http://www.jcancer.org/v07p0007.htm